Hazelwood House

Updated 4 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and one Expert by Experience who supported the inspector during the first day of this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Hazelwood House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Hazelwood House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who used the service to tell us about their experience of living at Hazelwood House. We spoke with 6 staff including the registered manager and deputy manager. We spoke with 1 visiting professional. We viewed 3 care and support plans, 3 medicines administration records and various records and documents in relation to the management of the service.

Updated 4 July 2023

Hazelwood House is a care home for older people and people under 65 years who have dementia and underlying mental health conditions. Hazelwood House provides the regulated activity of accommodation for people who require personal or nursing care. The service is registered to provide the regulated activity for up to 15 people. At the time of our inspection there were 14 people using the service, however 2 people were admitted to hospital.

People’s experience of using this service and what we found

Risks in relation to people receiving treatment and care were not managed appropriately.

Medicines were not always managed safely, guidance for the administration of specific medicines were not available.

Care records did not always clearly reflect peoples likes, dislikes, and wishes to provide staff with the relevant guidance to ensure care was provided in a person-centred way.

Quality assurance systems were in place, but these were not effective as they did not identify some of the shortfalls identified during our inspection.

The registered manager and provider acted upon feedback from the inspection and were in the process of addressing the issues identified.

People told us they felt safe at the service, and they could find a member of staff to help them. Staff rota's showed shifts were covered. Medicines were managed safely. People told us they were kept informed about their medicines and why they needed to take them.

Staff demonstrated they were aware of their safeguarding responsibilities and how to report concerns. Lessons learnt took place at the service after an incident and staff confirmed they took part in meetings to learn from lessons.

Staff were supported in their role and mostly received appropriate training.

People were able to enjoy food they liked and were supported to have enough to drink.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Consent to care and treatment was requested and staff did not force people to do something they did not want to.

The service worked well with external health professionals to ensure people received support when they became unwell. Care plans were person-centred and detailed peoples likes/dislikes and social history.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update - The last rating for this service was good (published 20 July 2021).

Why we inspected

The inspection was prompted in part due to concerns received about risks in relation to people receiving treatment and care not being managed safely. A decision was made for us to inspect and examine those risks.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive, and well led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Hazelwood House on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the management of risk, safe management of medicines, care plans not clearly reflecting people's needs and governance systems to improve the quality of the service not being fully embedded and effective.

We recommended that the service sought further guidance form a reputable source around the provision of tailored activities and the assessment of needs for people who used the service.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.